MEDICARE: FREEDOM HOME HEALTH OF INDIANA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency		IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376828764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM HOME HEALTH OF INDIANA, LLC

Provider Business Mailing Address
First Line	:	8435 KEYSTONE CROSSING
Second Line	:	SUITE 108
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-4373
Country	:	US
Telephone Number	:	317-359-3444
Fax Number	:	317-879-5657

Provider Business Practice Location Address
First Line	:	8435 KEYSTONE CROSSING
Second Line	:	SUITE 108
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-4373
Country	:	US
Telephone Number	:	317-359-3444
Fax Number	:	317-879-5657

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES M. PALAZZO
Credential	:
Telephone Number	:	847-515-1505

Provider Enumeration Date	:	10/17/2011
Last Update Date	:	03/07/2019

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